Written Answers Monday 26 June 2006

Scottish Executive

Dyslexia

Ms Rosemary Byrne (South of Scotland) (SSP): To ask the Scottish Executive what percentage of continuous professional development courses for teachers specifically address dyslexia awareness.

Peter Peacock: This information is not held centrally.

  However, you may be aware that the Executive has funded specific projects designed to assist the continuous professional development of teachers in dyslexia awareness.

  One involves an award to Dyslexia Scotland of £136,180 over the period 2004-07 to fund the Transition Project. The aim of this project is to produce a support package for pupils with dyslexia and their families to provide information on the often difficult transition from Primary to Secondary School. The project will also produce a CD-ROM as training material for teachers. There are also plans for a pre-transition course for S1 teachers involving P7 pupils with dyslexia and their families.

  In addition, the Executive awarded Dyslexia Scotland £100,000 over the period 2005-07 to fund the national co-ordinator project. The expected outcome of this project will be to have one key person (a teacher) for dyslexia in every primary school in Scotland and they will of course be expected to train other teachers in dyslexia issues.

Health

Marlyn Glen (North East Scotland) (Lab): To ask the Scottish Executive what percentage of drugs prescribed in NHS Tayside in each of the last three years have been generic drugs.

Lewis Macdonald: The following table shows the percentage of drugs prescribed generically in NHS Tayside during the financial years ending 31 March 2004 to 2006 inclusive. Data given refer to prescriptions dispensed in the community, but do not take into account medicines dispensed by hospitals or hospital based clinics.

  

 Health Board
 Financial Year
 Percentage of Drugs Prescribed Generically


 NHS Tayside
 2003-04
 82.0%


 NHS Tayside
 2004-05
 82.5%


 NHS Tayside
 2005-06
 82.9%

Mental Health

Jackie Baillie (Dumbarton) (Lab): To ask the Scottish Executive what action has been taken to improve the treatment of mental illness.

Lewis Macdonald: Action continues on improving treatment across the whole population from those who experience mild to moderate mental health problems to those with more severe and complex needs. The agenda centres on good health promotion, ill health prevention and improvements to the quality of care and treatment to help aid recovery.

  The new Mental Health (Care and Treatment) (Scotland) Act is a driver for further improvement in services with new rights, benefits and protections for all those who experience mental health problems, and their carers.

  A wide range of other initiatives is in hand at local, regional and national levels, backed by record resources, including attention to depression services through our "Doing Well" programme; perinatal mental health accommodation and services; support for crisis and out-of-hours care, and an ambitious health improvement and well-being agenda.

  Delivering for Health (Bib. number 37847) sets the forward direction for developing and improving health services and reflects the priority for mental health services. Our work on mental health will be brought together in a national mental health delivery plan to be published by the end of this year.

Mental Health

Jackie Baillie (Dumbarton) (Lab): To ask the Scottish Executive how much has been allocated to improve the treatment of mental illness in each year since 1999.

Lewis Macdonald: The Scottish Executive does not provide NHS boards or local authorities with a separate budget specifically for mental health services. Spend on mental health services will be drawn from the record funds allocated to these agencies, taking account of national and local priorities.

  The annual allocation for health in 2007-08 will be over £10 billion and the Grant Aided Expenditure to local authorities for social work will have increased to £2.085 billion.

  In addition to the general health expenditure, we have invested £41.485 million since 2003 to 2006 to help NHS boards and local authorities implement and deliver the Mental Health (Care and Treatment) (Scotland) Act 2003, with a further £5 million available through NHS boards in both 2006-07 and 2007-08.

  We have also invested £24 million from 2003 to 2006 for the work of the National Programme for Improving Mental Health and Well-being, with a further £18 million planned over 2006-08.

Mental Health

Stewart Stevenson (Banff and Buchan) (SNP): To ask the Scottish Executive how many young people have been waiting to access child and adolescent mental health services and what the average waiting time has been in each year since 1999, broken down by NHS board.

Lewis Macdonald: This information is not available.

NHS Hospitals

Irene Oldfather (Cunninghame South) (Lab): To ask the Scottish Executive what action it is taking in conjunction with NHS boards to make the best use of available acute sector beds.

Mr Andy Kerr: Making best use of beds in acute hospitals is an important operational responsibility for NHS boards. The Health Department supports a number of initiatives and programmes to help boards optimise the use of acute hospital beds. This includes programmes to manage acute hospital admissions, so that where possible patients are treated in other settings without the need for admission to hospital; targets and funding aimed at reducing delayed discharge of patients from acute beds; initiatives to increase the proportion of surgery that is carried out on a day case basis, reducing the demand on overnight beds, and the "streaming" of elective and emergency work to reduce disruption to elective surgery schedules as a result of emergency demands.

  These programmes and initiatives are consistent with and in many cases flow from Delivering for Health, published in November 2005, which set out the Executive’s vision for the future of the NHS. We recognise the importance of shifting away from a model of treating illness based on episodic, acute care in hospitals, increasingly through emergency admissions, towards a model of anticipatory and preventative care. In particular, Delivering for Health placed a requirement on all NHS boards to develop a three year development programme to introduce a number of changes, including treating day surgery (rather than in-patient surgery) as the norm for planned procedures, and actively managing discharge and length of stay. Delivering for Health can be accessed at:

  www.scotland.gov.uk/Publications/2005/11/02102635/26356.

Scottish National Blood Transfusion Service

Janis Hughes (Glasgow Rutherglen) (Lab): To ask the Scottish Executive whether it will make a statement on the future of the blood processing activities of the Scottish National Blood Transfusion Service, including the Protein Fractionation Centre.

Mr Andy Kerr: The Executive has been considering for some time the results of a strategic review of the future of Protein Fractionation Centre (PFC) and Alba Bioscience, and our future strategy for the supply of plasma products. The review has looked at whether plasma products should be made in Scotland or should be purchased from elsewhere. The key aim has been to secure a safe and sustainable source of high quality products that provides value for money for the taxpayer.

  The Scottish National Blood Transfusion Service (SNBTS) currently operates the PFC in Edinburgh to supply plasma products for the NHS in Scotland, together with Alba Bioscience which makes blood grouping reagents. Plasma products are important for many NHS patients in Scotland. For example, some people who lack normal immunity to infection are dependent on plasma products long-term. As these products are derived from human plasma safety is of the utmost importance, and manufacturing is tightly controlled and regulated.

  The role of the PFC has been significantly affected by a number of changes in recent years which mean that it is no longer viable in economic terms. Since 1998, as a precautionary measure because of vCJD risks, the PFC has purchased plasma from Germany and the US for manufacture of plasma products. Previously plasma was available free from blood donation in Scotland, and this has added significant new costs to the operation. There is no prospect of a return to the use of UK plasma in the foreseeable future.

  Since January this year, manufacturing at the PFC has been suspended following an inspection by the Medicines and Healthcare products Regulatory Agency (MHRA) which identified weaknesses in quality assurance processes. As a result plasma products are currently being bought in from outside Scotland, either from the NHS Bio Products Laboratory (BPL) in England or from commercial sources. A number of these products are more advanced and of higher quality than PFC products, and offer benefits for health professionals and patients. The PFC is at present unable to produce equivalent products. It would be unacceptable to return to using products that are of lower quality, and it would take a number of years to develop new products to the point of licensing. Indeed, there are strong clinical reasons which support the use of quality products from commercial sources, in particular in relation to patients with primary immuno-deficiency who are treated with immunoglobulin on a lifelong basis. These include patient safety, convenience and choice, treatment flexibility, service efficiency and sustainability of approach in immunoglobulin usage.

  In addition, the need for some products - such as blood clotting factors - is now met by recombinant products, rather then products based on human plasma, and this has reduced the value and output of products from the plant. The PFC’s production costs are now higher than the market value of its products and the facility also requires significant upgrading and investment (estimated at approximately £20 million) to bring the plant up to modern manufacturing standards, and to ensure continued compliance with regulatory requirements.

  Even with this substantial investment it is questionable whether the PFC, one of the smallest facilities of its kind in the world, would be an economic and viable operation with estimated long-term marginal costs of 20 to 25% above those of commercial competitors. Given secure and sustainable sources of commercial products which are of greater quality and safety, we have concluded that it would be both injudicious and inadvisable to invest further NHS resources in the PFC.

  As a result of the plant no longer being viable, we have decided not to authorise the full-scale resumption in production of the PFC product range. We have asked SNBTS to explore whether the plant can be sold, or whether some of its activities can be developed in the private sector in Scotland. The PFC has significant skills and knowledge, and some innovative products which could earn commercial returns. For example, PFC has been involved in a long-term collaboration with the Ministry of Defence (MoD) Defence Science and Technology Laboratory to produce and licence a heptavalent botulinum anti-toxin. The product is currently produced under the terms of a Manufacturer’s (Specials) Licence which enables it to be administered to individual patients under the supervision of a doctor, in the event of an emergency. It is the MoD’s intent to continue studies to support an application for a Marketing Authorisation (Product Licence) for the botulinum anti-toxin in due course. SNBTS believe there are potential commercial opportunities in the development of anti-toxin products which could be attractive to the private sector.

  This means that the future procurement route for plasma products for the NHS in Scotland will be from external sources in the same way as most modern pharmaceutical products are bought by the NHS. This will ensure a sustainable supply of high quality product for patients in Scotland.

  Alba Bioscience already has significant commercial business as well as supplying products to the NHS. We believe this is a potentially successful business with the opportunity for growth. We have asked SNBTS to develop and prepare Alba Bioscience for sale at an appropriate time.

  PFC is a manufacturing unit which produces a range of blood products from plasma. This decision about the future of PFC has nothing to do with the mainstream blood donor and collection activities of SNBTS. It is essential that people continue to support these by giving blood to save lives and enabling important operations to go ahead for people who need them

  There are at present 145 jobs in the PFC. We hope to find a buyer who would preserve as many of these jobs as possible. In the event that there is not a suitable buyer and plasma processing does not resume, we will aim to ensure as far as we can that staff are redeployed in the NHS in Scotland in terms of the national Organisational Change Policy. The NHS aims to offer its staff secure employment and, where possible, we will offer available and appropriate posts elsewhere in SNBTS or in the NHS. We cannot guarantee that these changes will involve no compulsory redundancies but we would aim to avoid them.

  Our first responsibility is to protect the interests of patients. We believe this approach is the best way to achieve this, recognising that it would not be a justifiable use of NHS resources to commit to significant additional investment in the PFC. It is through the continued sourcing of plasma products commercially that we can ensure a safe and sustainable supply of high quality products for the people of Scotland.

Smoking

Stewart Stevenson (Banff and Buchan) (SNP): To ask the Scottish Executive how many children have been treated for (a) tobacco addiction and (b) tobacco-related illnesses in each of the last five years, broken down by age and health board.

Lewis Macdonald: Table 1 presents the number of people aged 15 years and under, d ischarged from general acute Scottish hospitals with a diagnosis of Mental and behavioural disorders due to use of tobacco , from 2000-01 to 2004-05. None of these children had a specific diagnosis of dependence on tobacco.

  The numbers by age and health board are too low to be published without increased risk of disclosure of additional information about these individuals. Health boards with at least one case over the five year period were: Grampian, Highland, Lanarkshire and Lothian.

  There are a large number of conditions which could be related to smoking, but which could also have other causes. Whether a patient smokes or not is not recorded centrally on most routine datasets.

  In the future, data on people seeking help to stop smoking will be available from the new National Smoking Cessation Database, introduced in 2005. Statistics from this new resource will be made available once the quality and consistency of the data have been assured.

  Table 1 – Scottish General Acute Hospital Discharge Records: Number of People with an Explicit Diagnosis of Tobacco Misuse: 2000-01 to 2004-05P

  

 2000-01
 2001-02
 2002-03
 2003-04
 2004-05P


 2
 2
 2
 6
 2



  PProvisional.

Telecommunications

Mr Bruce McFee (West of Scotland) (SNP): To ask the Scottish Executive whether its Health Department has provided guidelines to the mobile telecommunications industry regarding the provision of information at point of sale on the specific absorption rate (SAR) values of mobile phones.

Lewis Macdonald: The major manufacturers of mobile phones co-operate on issues related to mobile phone technologies and health through their membership of the Mobile Manufacturers’ Forum (MMF). The MMF states that "SAR information for new model phones will be included with the materials that come with the mobile phone. In addition, this information will be available from the website of your mobile phone manufacturer". The Health Department has issued no additional guidelines to the mobile telecommunications industry.

Young Offenders

Christine Grahame (South of Scotland) (SNP): To ask the Scottish Executive what information it has on how frequently the Scottish Children’s Reporter Administration, the Association of Chief Police Officers in Scotland and COSLA publicly report on the number of persistent young offenders with whom they are dealing.

Cathy Jamieson: The Scottish Children’s Reporter Administration publish validated youth justice data both quarterly and annually.

  They also circulate monthly management data to local youth justice agencies on offence referral patterns and timeliness indicators.